Secondary sarcopenia assessed by computed tomography can predict hospitalization for heart failure in adults with Fontan circulation

•Sarcopenia is not rare in adults with Fontan circulation.•Skeletal muscle pumping is important in Fontan circulation.•Low volume of the psoas major muscle is predictive of heart failure in Fontan. Sarcopenia is one of the important predictors of heart failure (HF) in patients with cardiac problems. Skeletal muscle pump is important to maintain Fontan circulation. We aimed to quantify the volume of the psoas major muscle (PMM) and investigate whether it is relevant to HF hospitalization in adults with Fontan circulation. A total of 154 adults with Fontan circulation, and 30 age-matched adults were studied retrospectively. We identified secondary sarcopenia by measuring the PMM volume, using non-contrast abdominal computed tomography. PMM indexed volume in Fontan patients was lower than controls (206.4+/−18.0 cc/m2 vs 288.0+/−61.1 cc/m2, p